Virtual reality training versus conventional rehabilitation for chronic neck pain: A systematic review and meta-analysis.

Objective: To identify, critically appraise, and quantitatively synthesize current randomized controlled trials to compare the effects of virtual reality and dose-matched conventional exercises in patients with chronic neck pain.

Literature search: PubMed, Embase, CINAHL, PsycINFO, and Scopus were searched for studies published prior to April 15, 2023. The search strategies combined controlled vocabularies and title/abstract keywords on search themes of virtual reality and neck pain.

Methods: A systematic review and meta-analysis of randomized controlled trials was conducted. Two independent reviewers conducted study selection, data extraction, and quality assessment. Methodological quality was assessed using the Physiotherapy Evidence Database scale. Meta-analyses were performed using random-effects models.

Synthesis: Six randomized controlled trials including 243 participants with chronic neck pain met the inclusion criteria. Four studies were evaluated as good quality and two as fair. Pooled analysis revealed that virtual reality demonstrated significantly better improvements in the Neck Disability Index in both the short term (mean difference [MD] = -2.16; 95% confidence interval [CI]: -3.50 to -0.82) and long term (MD = -2.95; 95% CI: -4.93 to -0.97), and pain intensity in the short term (MD = -0.94, 95% CI: -1.31 to -0.58). No significant between-group differences were found in pain in the long term and kinesiophobia.

Conclusions: Virtual reality is a promising intervention to address disability and pain in patients with chronic neck pain. This review supports the clinical significance of augmenting conventional exercise with virtual reality as part of conservative management of chronic neck pain.